Uhlenbrock D, Seidel D, Gehlen W, Beyer H K, Haan J, Dickmann E, Zeit T, Herbe E
Radiological Clinic, Marienhospital Herne, University of Bochum, W. Germany.
AJNR Am J Neuroradiol. 1988 Jan-Feb;9(1):59-67.
MR examinations of 136 patients with multiple sclerosis (MS) were evaluated to correlate the results with clinical, CSF, and visual evoked potential (VEP) findings. In addition, 22 of the 136 patients were studied several times during a 5-month follow-up period. It was demonstrated that MR is superior to CSF and VEP findings in establishing cerebral alterations in MS. A relationship between the results of CSF and VEP examinations and the MR results could not be detected. Negative CSF and VEP results corresponded to positive MR imaging and vice versa. In our series, five negative MR results were obtained in patients with clinically proved MS. The extent of alterations shown up by MR corresponds to the duration of the disease; in particular, more confluent abnormalities in the periventricular region were found in patients with long-standing disease. More plaques were found in patients with a primary relapsing/remitting course of the disease than with the primary chronic progressive form. The clinical course and the grade of disability did not correspond to differences in MR imaging. Follow-up demonstrated that most lesions remain unchanged (72-79%); increases and decreases in the size of the plaques seem to depend on the clinical course. These results suggest that MR is the most sensitive technique for establishing the diagnosis of MS.
对136例多发性硬化症（MS）患者的磁共振成像（MR）检查结果进行了评估，以将其与临床、脑脊液（CSF）及视觉诱发电位（VEP）检查结果进行关联分析。此外，在5个月的随访期内，对136例患者中的22例进行了多次研究。结果表明，在确定MS患者脑部病变方面，MR优于CSF和VEP检查结果。未发现CSF和VEP检查结果与MR结果之间存在关联。CSF和VEP检查结果为阴性时，MR成像结果为阳性，反之亦然。在我们的研究系列中，临床确诊为MS的患者中有5例MR检查结果为阴性。MR显示的病变范围与疾病持续时间相关；特别是，病程较长的患者在脑室周围区域发现更多融合性异常。与原发性慢性进行性病程的患者相比，原发性复发/缓解型病程的患者发现更多斑块。临床病程和残疾程度与MR成像差异无关。随访显示，大多数病变保持不变（72%-79%）；斑块大小的增加和减少似乎取决于临床病程。这些结果表明，MR是确立MS诊断的最敏感技术。
